{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JAYLA GORDON","gend":1,"add":"4585 STATE PARK ROAD                                        ","city":"DUBLIN                        ","state":"VA","zip":"24084-6037","dob":"1997-09-10","age":"","mstatus":"","insh":6835475,"cliId":"","pno":5402309284,"cno":"","email":"","ename":"","eno":"","pphy":"KAATZ, MATTHEW S                                            ","ppno":5409800550,"pcpadd":"101 1st St NW                                               ,                                                            ","pcpcity":"PULASKI                       ","pcpstate":"VA","pcpzip":243015603,"pcpcounty":"","pcpid":"","pcpname":"KAATZ MATTHEW S MD PC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"4585 STATE PARK ROAD                                        ","add3":"","madd1":"4585 STATE PARK ROAD                                        ","madd2":"LOT 63                                                      ","madd3":"","mcity":"DUBLIN                        ","mstate":"VA","mzip":"24084-6037","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z32.01","Z36.87","Z3A.01","O21.9","O26.891","R11.2","O23.41","N92.6","Z34.91","Z36.82","Z3A.12","Z36.89","Z3A.21","R07.89","I34.0","R55","I08.1","Z29.13","Z34.83","Z23","Z3A.28","Z34.80","Z36.2","Z3A.29","Z67.91","Z87.59","Z39.1","Z34.82","O47.03","O34.33","Z3A.35","O99.413","R01.1","O26.893","O09.293","Z79.899","O36.5930","Z3A.36","O60.03","O09.213","Z88.1","O26.853","N85.8","O47.1","Z3A.37","Z3A.38","O80","Z37.0","Z3A.39","O99.42","O99.02","O99.62","D64.9","K21.9","R59.9","N39.0","R50.9","B96.20","B97.89","Z20.822","D72.810","R79.82","Z16.11","R91.8","J01.90","R51.9","Z11.3","Z76.89","W57.XXXA","S40.262A","R19.7"],"date":["2021-02-03","2021-02-03","2021-02-03","2021-01-28","2021-01-28","2022-11-13","2021-01-28","2021-02-03","2021-04-06","2021-03-05","2021-03-05","2021-05-04","2021-05-04","2022-10-26","2021-09-10","2021-06-03","2021-06-15","2021-06-25","2021-07-31","2021-06-25","2021-06-25","2021-06-25","2021-07-09","2021-07-09","2021-08-25","2021-08-25","2021-07-31","2021-07-31","2021-08-25","2021-08-17","2021-08-18","2021-08-31","2021-08-21","2021-08-29","2021-08-18","2021-08-18","2021-08-18","2021-08-29","2021-08-19","2021-08-21","2021-08-25","2021-08-29","2021-08-29","2021-09-08","2021-08-31","2021-09-08","2021-09-10","2021-09-10","2021-09-10","2021-09-10","2021-09-10","2021-09-10","2021-09-10","2021-09-10","2021-09-13","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2022-11-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2022-01-20","2022-10-26","2022-11-07","2022-11-07","2022-11-12","2022-11-12","2022-11-13"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","14","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","57237007810","ONDANSETRON","TAB 8MG ODT","9","Select","Select",""],["","27808023302","DOXYCYCL","CAP 100MG","42","Select","Select",""],["","00093220401","METOCLOPRAM","TAB 5MG","10","Select","Select",""],["","00536440601","VITAMIN","TAB 25MG","90","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","86790001960","SLOW","TAB 45MG","60","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}